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Biomedical subjects

W Hemmer

Publications and source records attributed to W Hemmer.

At least 73 records · Page 4Linked to original sources
PubMed1996

Patch test reactions in children, adults and the elderly. A comparative study in patients with suspected allergic contact dermatitis.

The age- and sex-related distribution of positive patch test reactions was investigated in 234 children (0-7 years, n = 72 and 8-14 years, n = 162), 1200 adults (20 to 50 years) and 295 elderly patients (> or = 70 years) with suspected allergic contact dermatitis using a European standard series. In girls from 0 to 7 years, the most frequent contact allergens were thimerosal (37.5%) and nickel (27.5%), in girls from 8 to 14 years, nickel (28.7%) and thimerosal (26.6%), in women, thimerosal (25.3%) and nickel (25.2%), and in elderly women, nickel (12.6%) and balsam of Peru (9.7%). The most frequent contact allergens in boys from 0 to 7 years were ethylmercuric chloride (28.1%) and thimerosal (25.0%), in boys from 8 to 14 years, thimerosal (30.9%) and ethylmercuric chloride (14.7%), in men, thimerosal (21.1%) and ethylmercuric chloride (13.7%) and in elderly men, nickel (11.2%) and balsam of Peru (6.7%). Females showed more positive reactions than males. Whilst 0 to 7 year-old girls and boys showed relatively more frequent reactions, the elderly of both sexes were clearly less affected. Nickel is the most frequent contact allergen in females of 8 years and more. In men, thimerosal is most frequent and reactions to balsam of Peru show a peak incidence in the elderly. Results indicate that patch testing should be considered in children and elderly patients with appropriate indications.

Adolescent↗
PubMed1996

'Hot spots' of creatine kinase localization in brain: cerebellum, hippocampus and choroid plexus.

Creatine kinase (CK) isoenzymes, with emphasis on the mitochondrial CK isoenzymes, were characterized and localized in chicken cerebellum. Chicken cerebellum extracts analyzed by two-dimensional gels, using antipeptide antibodies specific for sarcomeric muscle-type mitochondrial CK (Mib-CK) and revealed the presence of a Mib-CK variant in avian cerebellum. This CK isoform was localized by immunofluorescence staining exclusively in the Purkinje neurons. The co-expression of this Mib-CK together with cytosolic muscle-type MM-CK, as observed in the same Purkinje neurons, may reflect the specific energy requirements associated with highly fluctuating Ca2+ levels (Ca2+ spiking) in these specialized neurons. Ubiquitous brain-type mitochondrial Mia-CK was found together with cytosolic BB-CK mainly in the glomeruli structures of the cerebellar granular layer. BB-CK, but much less so Mia-CK however, was also very prominent in Bergmann glial cells of the two mitochondrial Mi-CK isoenzymes in the chicken cerebellum is demonstrated. Other hot spots of CK localization were the granule and pyramidal cells of the hippocampus in rat. There, a developmental stage-dependent immunofluorescence staining, especially with antibodies against Mia-CK was noted. Epithelial cells of the choroid plexus were also highly enriched in CK. The possible implications of a CK/PCr circuit at these various cellular locations of the brain are discussed with respect to normal brain physiology and pathology.

Animals↗
PubMed1996

Histamine in wine. Bronchoconstriction after a double-blind placebo-controlled red wine provocation test.

A 38-year-old woman with a history of seasonal rhinoconjunctivitis reported repeated attacks of wheezing after drinking various alcoholic beverages. Two consecutive histamine provocations using two identical samples of red wine containing 200 micrograms histamine/l and 3,700 micrograms/l, respectively, were performed in a double-blind placebo-controlled fashion to assess a possible histamine-induced bronchoconstriction. Lung function, plasma histamine, skin temperature, pulse rate and symptoms were assessed. In 3 male controls, four consecutive wine tests were performed in a randomised double-blind placebo-controlled fashion. Drinking wine with 3,700 micrograms histamine/l caused coughing and wheezing with a decrease in lung function. Plasma histamine showed an increase at 10 and 20 min and decreased at 30 min both after histamine-rich as well as histamine-poor wine, reaching the peak increase after histamine-rich wine. Controls did not react and plasma histamine levels did not increase. Bronchoconstriction after wine or food rich in histamine seems to be caused by diminished histamine degradation on the basis of reduced activity of diamine oxidase. Histamine in wine may induce bronchoconstriction in patients suffering from histamine intolerance.

Adult↗
PubMed1996

[Specific immunotherapy in allergies--evaluation of current status].

Specific immunotherapy is the treatment of choice in the therapy of inhalant allergies. Application route and dose regimen, selection and quality of allergens, as well as the individual patient represent different variables of immunotherapy to be considered. Premedication by oral antihistamines is mandatory for the reduction of side effects. Histamine-intolerance represents a contraindication for immunotherapy. Specific immunotherapy is highly efficacious leading to a 50-100% reduction of symptoms in nearly 90% of patients.

Allergens↗
PubMed1995

Autophosphorylation of creatine kinase: characterization and identification of a specifically phosphorylated peptide.

We report that several different chicken and rabbit creatine kinase (CK)1 isoenzymes showed an incorporation of 32P when incubated with [gamma-32P]ATP in an autophosphorylation assay. This modification was was shown to be of covalent nature and resulted from an intramolecular phosphorylation reaction that was not dependent on the CK enzymatic activity. By limited proteolysis and sequence analysis of the resulting peptides, the autophosphorylation sites of chicken brain-type CK could be localized within the primary sequence of the enzyme to a 4.5 kDa peptide, spanning a region that is very likely an essential part of the active site of creatine kinase. Homologous peptides were found to be autophosphorylated in chicken muscle-type CK and a mitochondrial CK isoform. Phosphopeptide as well as mutant enzyme analysis provided evidence that threonine-282(2), threonine-289 and serine-285 are involved in the autophosphorylation of CK. Thr-282 and Ser-285 are located close to the reactive cysteine-283. Thr-289 is located within a conserved glycine-rich region highly homologous to the glycine-rich loop of protein kinases, which is known to be important for ATP binding. Thus, it seems likely that the described region constitutes an essential part of the active site of CK.

Amino Acid Sequence↗
PubMed1995

Right ventricular function after coronary artery bypass grafting in patients with and without revascularization of the right coronary artery.

OBJECTIVES: To evaluate the influence of revascularization of a stenosis of the right coronary artery on right ventricular function. DESIGN: Prospective study. SETTING: Single institutional study in a university hospital. PARTICIPANTS: 20 patients with different degrees of stenosis of the right coronary artery undergoing elective coronary artery bypass grafting. INTERVENTIONS: In 10 patients, bypass surgery included revascularization of a significant stenosis of the right coronary artery (group 1). In 10 other patients, the pathology of the right coronary artery was judged to be not significant, without indication for revascularization (group 2). MEASUREMENTS AND MAIN RESULTS: Using the fast-response thermodilution pulmonary artery catheter, right ventricular function was estimated perioperatively. After termination of extracorporeal circulation, there was an increase in right ventricular volumes in group 2 (p < 0.05) and an initial decrease in group 1 (p < 0.05), with higher volumes in group 2 compared with group 1 (p < 0.05). The ejection fraction increased in group 1 (p < 0.05) and decreased in group 2 after operation (p < 0.05), with higher values in group 1 compared with group 2 (p < 0.05). In addition to these findings, the pressure-volume relationship showed a leftward and upward shift in group 1 and a rightward shift in group 2 postoperatively. CONCLUSIONS: These results indicate that right ventricular depression can occur after bypass grafting in patients with a moderate stenosis of the right coronary artery that is not revascularized. Revascularization of more severe stenosis of the right coronary artery appears to preserve postoperative right ventricular function.

Cardiac Volume↗
PubMed1995

Anaphylaxis after dental treatment with a formaldehyde-containing tooth-filling material.

A 67-year-old patient developed systemic reactions after application of a formaldehyde-containing tooth filling. She had a clearly positive RAST result for formaldehyde, whereas skin prick testing and patch tests were negative. Sensitization to formaldehyde appears to have occurred 1 year previously. Induction of formaldehyde allergy may represent a major complication during dental treatment, and assessment of specific IgE should be considered in patients at risk.

Aged↗
PubMed1994

Creatine kinase isoenzymes in chicken cerebellum: specific localization of brain-type creatine kinase in Bergmann glial cells and muscle-type creatine kinase in Purkinje neurons.

Creatine kinase isoenzymes were localized in the chicken cerebellum by the use of isoenzyme-specific anti-chicken creatine kinase antibodies. Brain-type creatine kinase was found in high amounts in the molecular layer, particularly in Bergmann glial cells but also in other cells of the cerebellar cortex, e.g. in astrocytes and in the glomerular structures, as well as in cells of the deeper nuclei. A mitochondrial creatine kinase isoform was primarily localized to the glomerular structures in the granule cell layer and was also identified in Purkinje neurons. Surprisingly, a small amount of the muscle-type creatine kinase isoform was identified in cerebellar extracts by immunoprecipitation, immunoblotting and native enzyme electrophoresis, and was shown to be localized exclusively in Purkinje neurons. Cell type-specific expression of brain- and muscle-type creatine kinase in Bergmann glial cells and Purkinje neurons, respectively, may serve to adapt cellular ATP regeneration to the different energy requirements in these specialized cell types. The presence of brain-type creatine kinase in Bergmann glial cells and astrocytes is discussed within the context of the energy requirements for ion homeostasis (K+ resorption), as well as for metabolite and neurotransmitter trafficking. In addition, the presence of muscle-type creatine kinase in Purkinje neurons, which also express other muscle-specific proteins, is discussed with respect to the unique calcium metabolism of these neurons and their role in cerebellar motor learning.

Animals↗
PubMed1994

[Abdominal complications following heart surgery].

OBJECTIVE: Intra-abdominal complications occurring after cardiopulmonary bypass operations are rare but often fatal. There are only speculative approaches concerning the pathogenesis and the risk factors of these complications. The aim of our study was therefore to determine the causative factors and to evaluate the diagnostic and therapeutic measures, because early diagnosis and immediate treatment is essential for the outcome of the patients. DESIGN: 500 consecutive patients who underwent cardiopulmonary bypass procedures over a period of 14 months were examined for intra-abdominal complications. The records of these patients were reviewed in relation to possible risk factors and the group with intra-abdominal complications was compared with a random sample of 50 patients in respect of possible risk factors. The diagnostic procedures (serum lactate concentrations, sigmoidoscopy, coloscopy) and the therapeutic interventions were also evaluated. MAIN RESULTS: 9 (1.8%) of the 500 patients developed intra-abdominal complications. The mortality rate was 44% (4 of 9). 5 patients had bowel necrosis or ischaemic colitis. Pseudo-obstruction appeared in 5 cases. One patient developed cholecystitis and one acute haemorrhagic pancreatitis. Gastroduodenal complications were not observed. There was no difference between the group with intra-abdominal complications and the random sample with regard to sex, type of operation and preoperative intra-abdominal diseases. Clinical risk factors identified were: age, occlusive vascular disease, atrial fibrillation, prolonged aortic cross-clamping times and mean bypass times, intraoperative and postoperative need for supply of epinephrine and norepinephrine, implantation of an intraaortic balloon counterpulsation pump, low cardiac output, postoperative multiple organ failure. 8 out of the 9 patients had severe intraoperative surgical complications or general complications in the postoperative course. All patients with bowel necrosis or ischaemic colitis had abnormal serum lactate concentrations. With the aid of sigmoidoscopy in one patient, only bowel necrosis or ischaemic colitis could be detected. In one patient with pseudoobstruction, an operation was probably obviated by decompression of the colon by coloscopy. 6 of the 500 patients after cardiopulmonary bypass required emergency laparotomy. Two patients with bowel necrosis were saved by early hemicolectomy. CONCLUSION: In reviewing both our results and data cited in earlier studies, intra-abdominal complications can generally be attributed to the following: Intraoperative surgical complications with the consequence of prolonged aortic cross clamping and total bypass times can cause low cardiac output and mesenteric hypoperfusion. Predominantly as a result of the low cardiac output, the use of vasopressors increases splanchnic ischaemia, in particular in patients with pre-existing occlusive vascular disease of the mesenteric arteries. Mucosal ischaemia might be aggravated by a concurrent pseudo-obstruction. On the other hand, intraoperative complications and low cardiac output can cause further complications and finally multiple organ failure. Multiple organ failure and ischaemia of the gut can initiate the vicious circle which is responsible for the high mortality from these complications. Early detection by careful physical examination and the combination of the diagnostic procedures and prompt treatment should lead to a reduction of mortality.

Abdomen↗
PubMed1993

Effect of okadaic acid on protein phosphorylation patterns of chicken myogenic cells with special reference to creatine kinase.

Okadaic acid and other agents affecting cellular phosphorylation and dephosphorylation processes profoundly changed the phosphoprotein pattern of 32Pi-labelled chicken embryonic skeletal muscle cells. The phosphorylation states of proteins in the lower molecular weight range were especially increased. Immunoprecipitation of cellular extracts with anti-creatine kinase antibodies enabled us to identify creatine kinase (CK) phosphoproteins. B-CK was phosphorylated after treating the cultures with 1-oleoyl-2-acetyl-sn-glycerol, dibutyryl-cAMP, okadiac acid and combinations thereof, but not with 1,2-dioleoyl-sn-glycerol. M-CK was also shown to be phosphorylated. The results indicated that in vivo, CK isoforms in muscle are subjected to control mediated by phosphorylation and dephosphorylation processes.

Amino Acid Sequence↗
PubMed1993

Patient selection for ICD treatment and peri-operative mortality.

In view of the reported high risks resulting from the implantation of a cardioverter (ICD) and our own experience, we retrospectively evaluated the patients who received an ICD at our institution, so as to predict factors that could lead to a high peri-operative risk. The patients were divided into three groups according to their diagnoses and the surgical procedure. Group I: 10 patients with non-ischaemic cardiomyopathy, age 53.9 +/- 14.0 years, ejection fraction (EF) 33.1 +/- 11.8; group II:13 patients with coronary artery disease (CAD), diffuse arteriosclerosis, age 60.0 +/- 6.8 years, EF 31.4 +/- 9.1%; group III:12 patients, age 61.9 +/- 9.4 years, EF 41.2 +/- 8.6, CAD, concomitant bypass grafting. In cases of cardiomyopathy, cardiac complications (30%) were reversible by adequate drug therapy. However, five patients in group II (38.5%) died from cardiac complications, mainly frequent arrhythmias and subsequent pump failure. In group III no peri-operative complications occurred. Therefore the high mortality (overall 13.2%) in our series was exclusively due to patients suffering from severe CAD and unsuitable for revascularization. Considering the high risk after ICD placement, primary heart transplantation might be the better procedure in younger patients with end-stage CAD.

Adult↗
PubMed1993

Functional aspects of creatine kinase in brain.

The distinct isoenzyme-specific localization of creatine kinase (CK) isoenzymes found recently in brain suggests an important function for CK in brain energetics and points to adaptation of the CK system to the special energy requirements of different neuronal and glial cell types. For example, the presence of brain-type B-CK in Bergmann glial cells and astrocytes is very likely related to the energy requirements for ion homeostasis (K(+)-resorption) in the brain, as well as for metabolite and neurotransmitter trafficking between glial cells and neurons. In contrast, the presence of muscle-type M-CK, found exclusively in Purkinje neurons which also express other muscle-specific proteins, is very likely related to the unique calcium metabolism of these neurons. In addition, the developmentally late appearance of mitochondrial CK (Mi-CK) during brain development indicates an important function for Mi-CK in the oxidative energy metabolism of the brain. The physiological importance of the phosphocreatine circuit fully operating in adult brain has been corroborated by recent data from in vivo 31P-NMR magnetization transfer measurements. Future investigations should concentrate on the possible involvement of CK in diseases of the CNS with altered energy metabolism, aspects of which are also discussed here.

Animals↗
PubMed1993

Functional maturation of creatine kinase in rat brain.

The physiological role of the phosphocreatine (PCr)/creatine kinase (CK) system has been studied in rat brain by comparing maturational changes in in vivo CK-catalyzed reaction rate and activities of CK isoenzymes. The CK-catalyzed reaction rates, measured by 31P-nuclear magnetic resonance spectroscopy, increased 4-fold between 12 and 17 days of age. The mitochondrial CK (Mi-CK) isoenzyme, as a percentage of total CK, increased to the same extent over this relatively narrow age period. Cytosolic CK (B-CK) was active earlier and, with the total CK activity, increased steadily over a longer time course. An immunohistochemical study of cerebellum showed Mi-CK predominantly in gray matter, while the cytosolic CK was present in rather large concentrations in both gray and white matter. In the molecular layer, B-CK was most prominent in the Bergmann glial cells, while Mi-CK was more prominent in Purkinje neurons. During development a redistribution of Mi-CK from the Purkinje cell bodies to their processes was observed. These results point to regional differences in CK content and in isoenzyme-specific localizations. The increase in CK activity is temporally coincident with the maturational appearance of closely coupled decreases in brain PCr and ATP during hypoxia. These maturational changes suggest that the activity of the PCr/CK system, particularly the Mi-CK isoenzyme, is central in regulation of brain ATP.

Animals↗